腹膜透析患者的营养状况评价及影响因素分析

The nutritional status and influencing factors of peritoneal dialysis patients

目的探讨持续不卧床腹膜透析(CAPD)患者的营养状况以及影响因素分析。方法 CAPD患者40例,采用主观综合性营养评估法(SGA)对患者进行营养状况给予评价判断,根据结果分为营养良好组、轻中度营养不良组、重度营养不良组,测定3组患者血肌酐(Scr)、血清白蛋白(ALB)、血清前白蛋白(PA)、C反应蛋白(CRP)、二氧化碳结合力(CO2CP)、胆固醇(CH),以及进行腹膜溶质转运特性测定分类。对比3组各项指标的差异。结果经过测定40例CAPD患者营养良好25例(62.5%),轻中度营养不良10例(25%),重度营养不良5例(12.5%)。3组间Scr、ALB、PA、CRP、CO2CP、CH指标对比差异有统计学意义(P<0.05)。营养良好组患者中,低转运、低平均转运有22例,占88.0%,高平均转运仅3例;15例营养不良(轻中度营养不良组+重度营养不良组)患者中,高转运和高平均转运患者13例,占86.67%,低转运、低平均转运各1例,两组腹膜平衡结果差异具有统计学意义(P<0.01)。结论 CAPD患者的营养不良发生率非常高,且腹膜转运类型大都属于高转运以及高平均转运类型,Scr、ALB、PA、CRP、CO2CP、CH是影响患者营养状况的重要因素,对有关影响因素进行纠正,有助于改善患者的营养状况提高与改善。

Objective To investigate nutritional status and influencing factors of continuous ambulatory peritoneal dialysis（CAPD） patients.Methods Forty cases of CAPD admitted to our hospital from July 2009 to 2011 July enrolled the study.Subjective global nutritional assessment（SGA） was used to evaluate the nutritional status of patients.According to the nutritional status,the patients were divided into normal nutrition group,mild to moderate malnutrition group,and severe malnutrition group.Serum creatinine（Scr）,albumin（ALB）,prealbumin（PA）,C-reactive protein（CRP）,carbon dioxide combining power（CO2CP）,cholesterol（CH）,and peritoneal transport characteristics were determined and compared among the three groups.Results Determination of nutritional status of 40 CAPD patients were normal nutrition in 25（62.5%）,mild to moderate malnutrition in 10（25.0%）,and severe malnutrition in 5（12.5%）.There were significant differences in the levels of Scr,ALB,PA,CRP,CO2CP,and CH among the three groups（P0.05）.Of 25 patients with normal nutrition,low transport and low average transport were found in 22（88%）;of 15 malnourished patients,the high transport and high average transport were found in 13（86.67%）（P0.01）.Conclusion The occurrence of malnutrition in CAPD patients is very high,and the peritoneal transport type of malnutrition patients mostly belongs to the high transport and high average transport type.Scr,ALB,PA,CRP,CO2CP and CH are important factors of nutritional status in CAPD patients.The correction of these factors may help to improve the nutritional status of patients.